Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amanda Lariscey, PA-C

Individual provider Physician Assistant · NPI 1780164590

Amanda Lariscey, PA-C is a Physician Assistant in Vidalia, Georgia. Qualified in 2018, 8 years ago. Practices with Vidalia Immediate and Primary Care LLC, a 10-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
8
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

122 Alice Coleman Dr
Vidalia, GA 30474
Phone: (912) 805-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1780164590
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 21, 2018
Last updated in NPPESJanuary 7, 2022
Certification dateJanuary 4, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Vidalia Immediate And Primary Care Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Vidalia